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Primary FRCA MCQ > ELFH > Flashcards

ELFH Flashcards

1
Q

Which Mapleson system is most efficient for spontaneously ventilating patients

A

Mapleson A

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2
Q

What is the name of the co-axial version of Mapleson A circuit

A

Lack system

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3
Q

What is the volume of an adult reservoir bag in a breathing circuit

A

2L

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4
Q

What is a Jackson-Rees system

A

Mapleson F

Has an open ended reservoir bag which allows PEEP and controlled leak

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5
Q

Give 4 roles/benefits of a reservoir bag on breathing system

A

1- Allow higher peak inspiratory flow to be delivered as ventilator alone is not enough for normal respiration

2- Rough visual assessment of ventilating volume

3- provide PEEP

4- Prevent wastage of FGF during expiratory pause

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6
Q

How many multiples of minute ventilation does a Bain system require to prevent rebreathing during spontaneous ventilation

A

2-3X

(Mapleson D)

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7
Q

Why is Magill system inefficient during controlled ventilation

A

APL valve at patient side of circuit so most of expired gases are vented off.

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8
Q

What size are soda lime granules

A

4-8 mesh

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9
Q

What are the constituents of baralyme

A

80% Calcium hydroxide
20% Barium Hydroxide

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10
Q

Does soda lime produce more or less compound A during low FGF

A

More

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11
Q

What are the constituents of Sodalime

A

75% Calcium Oxide (CaO)
20% Water
3% Sodium hydroxide (NaOH)
1% Potassium hydroxide (KOH)

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12
Q

Why can FIO2 slowly decrease over time during low flow anaesthesia

A

If metabolic requirements exceed O2 supply in FGF the oxygen conc. in the system will start to decrease

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13
Q

What is the MAC of Nitrous Oxide

A

105%

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14
Q

How does water affect sodalite efficiency

A

Water is generated by the overall reaction of CO2 with soda lime but it’s presence or absence does not influence performance of sodalite

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15
Q

Can Nitrous Oxide be safely delivered using a quantiflex mixer? How does this work?

A

Yes.

Quantiflex mixer allows a full range oxygen/nitrous oxide mixtures to be administered from 21-100% oxygen so avoiding accidental hypoxic mixtures.

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16
Q

Why can nitrous oxide not be used as an anaesthetic agent by itself?

A

MAC is 105% so can’t deliver enough whilst also giving oxygen

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17
Q

What is the pin index of nitrous oxide

A

3, 5

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18
Q

What colour is the collar of a nitrous oxide cyllinder

A

French Blue

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19
Q

What is the difference between a Magill and Lack system

A

APL valve is at machine end in Lack system

In Lack system there is an inner co-axial tube for expired gas and FGF is on external limb.

20
Q

What proportion of MV is required for spontaneous ventilation using Magill circuit

A

70% of MV

21
Q

Summarise Cardiff Aldasorber

A

Canister containing charcoal that acts as passive scavenger. Absorbs anaesthetic gasses including isoflurane but not Nitrous oxide. Low resistance. Can be reactivated by heating to remove absorbed gasses. No indicator die so hard to tell when saturated.

22
Q

When filled what percentage of the volume of a canister is taken up by sodalime granules

A

50%

23
Q

Which anaesthetic gas causes production of Compound A in soda lime

A

Sevoflurane

24
Q

Which 3 anaesthetic gases cause production of CO in soda lime

A

DIE

Desflurane
Isoflurane
Enflurane

25
Q

What is the purpose of the gold lining of the rotameter

A

Anti-static

26
Q

Define critical gas velocity

A

The velocity of a gas at which it changes from laminar flow to turbulent flow

27
Q

How does helium reduce turbulent flow in respiratory system

A

Helium has lower density than air/O2. Reduces Reynolds number.

28
Q

What effect can water vapour have on a Fleisch pneumotachograph

A

Water vapour can block pressure transducers or smaller tubes in the pneumotachograph

29
Q

How does the length of a tube affect resistance to flow

A

Resistance is directly proportional to length of tube in laminar flow.

Flow = Pressure difference/ resistance

Flow = pressure difference X π R 4 / 8 X Viscosity x Length

30
Q

How does temperature affect Reynold’s number

A

Increasing temperature decreases density of a gas which decreases Reynolds number

31
Q

Can flow through an orifice be laminar

A

Flow through an orifice is always turbulent and affected by density

32
Q

How does haematocrit affect flow in blood vessels

A

Reduced haematocrit = reduced viscosity of blood.

This increases flow (Hagen Poiseuille)

Increases likely hood of turbulent flow ( reducing viscosity increases Reynolds number)

33
Q

How does flow affect resistance in laminar flow

A

Resistance is independent of flow when flow is laminar

34
Q

How does flow affect resistance in Turbulent flow

A

Increase in flow causes an exponential increase in resistance

35
Q

What is 1 torr equivalent to in mmHg

A

1 mmHg

36
Q

What is 1 ATM equivalent to in cmH2O

A

1035 cmH2O

37
Q

What is the mechanism of action of Clozapine

A

Partial agonist at D2 receptors

38
Q

What is the difference between EC50 and ED50 of a drug

A

EC50: The dose of the drug required to cause 50% of maximal effect

ED50: The dose required to cause cause the therapeutic effect in 50% of the population

39
Q

Is cAMP hydrophilic or Hydrophobic

A

Hydrophilic

40
Q

List 4 mixed agonist - antagonist drugs

A

Pentazocine
Buprenorphine
Mirtazepine
Xameterol

41
Q

How to you get the time constant from the rate constant

A

Time constant = 1 / rate constant

42
Q

To what percentage of its initial activity does a negative exponential process fall after 1 time constant

A

37%

(1/e)

43
Q

Which subunits make up an ACh receptor

A

2 alpha sub units
1 Beta sub unit
1 Delta sub unit
1 epsilon sub unit

44
Q

How does the ACh receptor differ in the foetus compared to adult

A

The foetal receptor has a gamma sub unit instead of the adult epsilon sub unit

45
Q

Which receptors does Midazolam act on

A

GABAa receptors

46
Q
A

Primary FRCA MCQ (6 decks)

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